19D1026659 CLIA NUMBER - GREEN CLINIC JONESBORO

Laboratory Demographics

  • CLIA Code: 19D1026659
  • Facility Name: GREEN CLINIC JONESBORO
  • Facility Address: 4707 QUITMAN HIGHWAY
    HODGE, LA
    ZIP 71247
  • Facility Phone: 318 395-1168
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANE M. MCVAY
  • NPI Number: 1831178755
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D1026659
LAB Type Physician Office
Facility Name GREEN CLINIC JONESBORO
Street 4707 QUITMAN HIGHWAY
City HODGE
State LA
ZIP 71247
Phone 318 395-1168
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director SHANE M. MCVAY

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This page was last updated on: 9/29/2025